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NPI Code Detail

MEDICARE: REED CARL MCCLINTOCK

MEDICARE: REED CARL MCCLINTOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2372600000XAdult Companion

General Provider Information

NPI Number : 1225499536
Entity Type Code : Individual
Provider Name (Legal Business Name) : REED CARL MCCLINTOCK
Provider Business Mailing Address
First Line : 209 SW 4TH AVE STE 520
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1825
Country : US
Telephone Number : 503-988-5464
Fax Number :
Provider Business Practice Location Address
First Line : 209 SW 4TH AVE STE 520
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1825
Country : US
Telephone Number : 503-988-5464
Fax Number : 503-988-4386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2016
Last Update Date : 11/26/2024

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Directions to “ REED CARL MCCLINTOCK ” Practice Location

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